Intramucosal denture system

ABSTRACT

A denture adhering system includes an oral insert for securing a denture to the mucosal tissue covering a patient&#39;&#39;s jawbone comprising a mushroom-shaped head, a base wider than the head and having generally planar top and bottom portions, and a neck narrower than the head and connecting the head to the base. The top base portion is significantly narrower than the bottom base portion and is undercut to provide an outwardly opening groove adapted to engagingly receive means for securing the base to the denture. The underbody of the head defines a downwardly opening groove disposed about the neck and adapted to engagingly receive mucosal tissue, and preferably the upper surface of the top base portion defines an upwardly opening groove also disposed about the neck and adapted to engagingly receive mucosal tissue. Also included in the denture adhering system are a removable resilient sleeve which extends over the insert head and neck to protect the vertically opening grooves from being filled with cement during cementing of the insert base to the denture, a self-limiting self-leveling denture burr for preparing a recess in the denture to receive the insert base, a self-centering trimming burr for removing excess cement from adjacent the base after the base has been cemented to the denture, and a selflimiting self-leveling tissue burr for preparing a suitable receptacle in the mucosal tissue to engagingly receive the insert head and neck.

United States Patent 1191 Weiss et al.

[ Sept. 16, 1975 I INTRAMUCOSAL DENTURE SYSTEM [75] inventors: Charles M. Weiss; Kenneth Judy,

both of New York, NY.

[52] US. Cl 32/10 A [51] Int. Cl. N6lc 13/08 [58] Field of Search t. 32/10 A [56] References Cited UNITED STATES PATENTS 2,374.422 4/]945 Dahl 32/[0 A Primary E.ruminerRobert Peshock [57 ABSTRACT A denture adhering system includes an oral insert for securing a denture to the mucosal tissue covering a patients jawbone comprising a mushroom-shaped head a base wider than the head and having generally planar top and bottom portions, and a neck narrower than the head and connecting the head to the base. The top base portion is significantly narrower than the bottom base portion and is undercut to provide an outwardly opening groove adapted to engagingly receive means for securing the base to the denture. The underbody of the head defines a downwardly opening groove disposed about the neck and adapted to engagingly receive mucosa] tissue, and preferably the upper surface of the top base portion defines an upwardly opening groove also disposed about the neck and adapted to engagingly receive mucosal tissue Also included in the denture adhering system are a removable resilient sleeve which extends over the insert head and neck to protect the vertically opening grooves from being filled with cement during cementing of the insert base to the denture, a self-limiting self-leveling denture burr for preparing a recess in the denture to receive the insert base, a self-centering trimming burr for removing excess cement from adjacent the base after the base has been cemented to the denture, and a self-limiting self-leveling tissue burr for preparing a suitable receptacle in the mucosa] tissue to engagingly receive the insert head and neck 23 Claims, 13 Drawing Figures PATENTEBSEP I 61975 SHEEIIUF 2 FIG! PATENTEU SE31 8 F975 FIG. l2

sum 2 of 2 [NTRAMUCOSAL DENTURE SYSTEM DESCRIPTION OF THE PRIOR ART When a patient requiring a denture lacks sufficient teeth to provide an adequate anchor for securing the denture in place, it is known to utilize intramucosal oral inserts to secure the denture directly to the palatal mu cosal tissue covering the patients jawbone. The intramucosal oral inserts are tiny structures having a mushroomshaped head adapted to be seated in the mucosal tissue, a base adapted to be secured to the denture and a neck connecting the head and the base. While such intramucosal inserts represent a substantial innovation in dental technology, they have not proven to be entirely satisfactory in use due to the failure of the mucosal tissue to securely retain the insert head. Equally important, the high degree of precision labor required for proper seating of the insert within the denture and within the mucosal tissue has made this a diffi cult and expensive procedure, especially from the point of view of the infirm and elderly who are often most in need of this service.

The first step of the procedure requires the dentist to drill recesses in the denture to receive the base of the insert, approximately 14 inserts being used per typical denture and one recess being required per insert. The inserts are customarily arranged in two offset or stag; gered rows; one row is disposed so as to enter the crest of the ridge in the patients mouth, and other row, the palatal slope. Each recess drilled within the denture must be capable of receiving the base of the insert and retaining the axis of the neck normal to the plane of the denture in the area of the recess. A suitable adhesive, such as acrylic cement, is utilized to secure the insert base within the denture. During insertion of the insert base into the denture recess, a certain amount of flash or excess cement invariably is squeezed upwardly out of the recess and onto the surfaces of the insert and denture which will be in contact with the mucosa] tissue. This flash must be ground down and removed to provide a flush surface across the denture and insert base, without injuring either the denture or the insert.

The next step is for the dentist to ascertain precisely where on the mucosal tissue each of the insert heads will be located and to provide in each such location a cavity or receptor site to receive the insert head and neck. As the insert is removably retained in the mucosal tissue without the benefit of any adhesive, the receptor site must be formed with great precision to facilitate insertion of the insert within the mucosal tissue and eventual regeneration of the tissue about the head and neck of the insert so as to retain it in place. The depth, width and angle of the receptor site are all critical factors. Furthermore, while an error in the formation of a recess in a denture is correctable by repair of the denture, an error in the formation ofa receptor site within the mucosal tissue is less susceptible of correction for obvious reasons.

There is an initial healing period of six to eight weeks during which the mucosal tissue forming the interior lining of the receptor site reg nerates and grows about the insert head and nctk to form a resilient socket for the insert. The insert is usually snapped out of the resil ient socket about once every three days for cleaning. then snapped back into place.

To mitigate the degree of expensive, fatiguing and time-consuming precision labor required in the use of intramucosal inserts and to enable such inserts to be more rapidly and securely connected to the denture and to simplify the establishment of receptor sites with less possibility of error, an integrated and organized system for carrying out the above-described procedure is required. The system should include special in tramucosal inserts and dental tools specifically designed for rapid, error-free interaction with such inserts as well as the tissues and the dentures which receive such inserts.

Accordingly, it is an object of the present invention to provide a denture adhering system including an intramucosal insert of novel configuration permitting a more secure connection to the mucosal tissue as well as the denture.

It is also an object to provide such a system which includes sleeve means for protecting the novel configuration of the insert from being effectively modified by stray cement during engagement of the insert in the denture.

Another object is to provide such a system which in cludes a self-limiting self-leveling denture burr for preparing insert-receiving recesses of predetermined diameter and depth in the denture and a self-limiting selfleveling tissue burr for preparing receptor sites of pre determined diameter and depth in the mucosal tissue, the aforesaid burrs facilitating errorless precision formation ofsuch recesses and sites in a minimum of time.

Another object is to provide such a system including a self-centering trimming burr for removal offlash from the denture, the insert and therebetween.

A further object is to provide a dental kit for securing a denture to the mucosal tissue of a patient's jawbone comprising the above-mentioned apparatus.

SUMMARY OF THE INVENTlON It has now been found that the above and related objects of the present invention may be provided by a denture adhering system including an intramucosal insert for securing a denture to the mucosal tissue adjacent a patients jawbone comprising a mushroom shaped head adapted to be seated in mucosal tissue, a base wider than the head, and a neck narrower than the head connecting the head to the base. The base has a generally planar bottom portion and a generally planar top portion, the top base portion being substantially narrower than the bottom base portion and being undercut to provide an outwardly opening groove adapted to engagingly receive means for securing the base to a denture. The underbody of the head defines a downwardly opening groove disposed about the neck and adapted to engagingly receive mucosal tissue.

In a preferred embodiment the upper surface of the top base portion defines an upwardly opening groove disposed about the neck and adapted to engagingly receive mucosal tissue, the upwardly opening groove of the base and the downwardly opening groove of the head being circular and vertically aligned. The upper surface of the head is convex and has a centrally located upwardly projecting teat at the top thereof which may contain pressure-transferrable marking means disposed thereon. The maximum width of the top base portion is preferably closer to the maximum width of the head than the maximum width of the bottom base portion.

The denture adhering system additionally includes a sleeve adapted to be removably slipped over the head and neck of the insert prior to cementing of the insert to a denture. The sleeve comprises a bottom end adapted to be supported on the upper surface of the top base portion outwardly of the upwardly opening groove thereof and a side wall extending upwardly from the bottom end and snugly engaging the head periphery when the bottom end is supported on the upper surface, whereby the sleeve protects the upwardly and downwardly opening grooves from being filled with cement during cementing of the insert to a denture. Preferably the sleeve is a hollow cylinder of resilient nonstick material having a normal configuration with an inner diameter slightly less than the maximum diameter of the head and an outer diameter approximately equal to the maximum diameter of the top base portion and substantially less than the maximum diameter of the bottom base portion.

The denture adhering system additionally includes a self-limiting self-leveling denture burr for preparing in a denture a recess of predetermined diameter and depth to receive an insert. The denture burr comprising an elongated body having a drill-engaging end adapted to be engaged for rotation by a drill. a cutting end having a maximum effective diameter substantially equal to the maximum diameter of the base. and flange means extending outwardly of the body portion and spaced from the cutting end by approximately the maximum depth of the base to prevent over-cutting of a re cess by abutment against the adjacent surface of the denture. Preferably the flange means of the denture burr is spaced from the cutting end by slightly more than the maximum depth of the base to insure that the entire upper surface of the top base portion is disposable slightly below the tissue-contacting surface of the denture.

The denture adhering system additionally includes a self-centering trimming burr for removing excess cement from adjacent the base after the base has been cemented to a denture. The trimming burr comprises an elongated body having a drill-engaging end adapted to be engaged for rotation by a drill and a cutting end having a downwardly opening cavity with an interior surface cooperatively configured and dimensioned to loosely receive and center itself upon at least a portion of the upper surface of the head. The interior surface cooperates with the head to center the trimming burr over the insert. and the interior length of the cavity is at least equal to the distance between the upper surface of the head and the upper surface of the top base portion, thereby to enable removal of excess cement from above the plane of the upper surface of the top base portion of the insert when the burr cavity is seated over the insert head.

Preferably. the interior cavity length slightly exceeds the aforementioned distance. and the cutting end extends inwardly over at least part of the top base portion and outwardly beyond the maximum diameter of the top base portion when the burr cavity is seated over the insert head. Furthermore. in a preferred embodiment the cutting end extends outwardly beyond the maxi mum diameter of the base when the burr cavity is seated over the insert head. and the cutting end is provided with side vents to enable self-cleaning action dur ing rotation thereof.

The denture adhering system additionally includes a seIHimiting self-leveling tissue burr for preparing a receptor site of predetermined diameter and depth in mucosal tissue to engagingly receive an insert. The tissue burr comprises an elongated body having a drillengaging end adapted to be engaged for rotation by a drill. a cutting end having a maximum effective diameter slightly less than the maximum diameter of the head. and flange means extending outwardly of the body portion and spaced from the cutting end by approximately the combined maximum depth of the head and neck to prevent over-cutting of tissue by abutment against the surface of adjacent tissue.

BRIEF DESCRIPTION OF THE DRAWING FIG. I is a side elevational view. partially in cross section, of an intramucosal insert according to the present invention;

FIG. 2 is a top elevational view of the intramucosal insert of FIG. 1;

FIG. 3 is a side elevational view. partially in crosssection. of a sleeve according to the present invention;

FIG. 4 is a front elevational view of the sleeve of FIG.

FIG. 5 is a side elevational view'of a denture burr according to the present invention inserted in a drill bit indicated fragmentarily in phantom;

FIG. 6 is a front elevational view. to slightly enlarged scale. of the cutting end of the denture burr of FIG. 5;

FIG. 7 is a side elevational view of a trimming burr according to the present invention;

FIG. 8 is a front elevational view. to slightly enlarged scale. of the cutting end of the trimming burr of FIG.

FIG. 9 is a side elevational view of a tissue burr according to the present invention;

FIG. 10 is a front elevational view. to a slightly enlarged scale. of the cutting end of the tissue burr of FIG. 9;

FIG. 11 is a cross-sectional view of the sleeve of FIGS. 3 and 4 titted on the insert of FIGS. I and 2;

FIG. 12 is a fragmentary cross-sectional view of the trimming burr of FIGS. 7 and 8 seated on the insert of FIGS. 1 and 2, the insert being cemented to a denture; and

FIG. 13 is a fragmentary cross-sectional view of a denture connected to intramucosal tissue by the insert of FIGS. I and 2.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS Throughout this document the intramucosal inserts and the denture and mucosal tissue in which they are inserted will be described with reference to an upper denture so that the base of the insert is seated in an upwardly opening recess on the tissue (top) surface of the denture and the head of the insert projects upwardly into a downwardly opening receptor site or cavity in the mucosal tissue covering the patients upper jawbone. Accordingly. reference will be made throughout to directions such as upwardly and downwardly. topand bottom; and in the context of an oral insert in a upper bridge such directions correspond in fact to the indicated directions. Obviously. however. the intramucosal insert can also be used in a lower denture. in which case the directions will be reversed by I from the commonly understood orientations. For

the sake of simplicity and consistency, throughout this document the terms upwardly or top" and downwardly" or bottom" refer to the head and base, respectively, of the intramucosal insert, and have signifcance only with respect to the relative location of the parts thereof and not with reference to any absolute spatial orientation.

THE INTRAMUCOSAL INSERT Referring now to the drawing, and in particular to FIGS. I and 2 thereof, therein illustrated as part of a denture adhering system according to the present invention is an intramucosal insert generally designated by the numeral 10 and comprised of a mushroomshaped head generally designated by the numeral 12, a base generally designated by the numeral 14 and a neck 16 connecting the head 12 and the base 14.

The head 12 is mushroom-shaped and preferably provided at the centrally located top of the convex upper surface thereof with an upwardly projecting teat 20 and on the lower surface thereof with a downwardly opening groove 22, the functions of which will be described in detail hereinafter. The neck 16 is cylindrical and connected at one end to the lower surface of head 12 and at the other end to the upper surface of base 14. It will be noted that the diameter of the neck 16 is substantially less than the maximum diameter of the head 12 and that the downwardly opening groove 22 closely surrounds the neck 12.

The base 14 is comprised of a top portion 24 and a bottom portion 26, both portions being relatively planar and circular. The diameter of the top base portion 24 is substantially less than the diameter of the bottom base portion 26, but substantially greater than the diameter of the neck 16; preferably the top base portion diameter is closer to the neck diameter than the bottom base portion diameter. The base 14 is provided intermediate the top and bottom base portions 24, 26 with an outwardly or radially opening circumferential groove 30, and the upper surface of the top base portion 24 preferably has an upwardly opening groove 32 which faces and is vertically aligned with the downwardly opening groove 22 of the head 12, the function of each of these grooves being described in detail hereinafter. Preferably, the vertically aligned facing grooves 22, 32 are concentric and of substantially equal diameter, both being disposed immediately adjacent the ends of the neck 16.

Referring now to FIG. 13 which shows the intramucosal insert 10 in use, it will be noted that the head 12 and neck 16 thereof are disposed within a cavity or receptor site 34 in the mucosal tissue 36 while the base 14 is disposed within a recess 38 in the upper or tissue surface of an acrylic upper denture 40. The base of the denture recess 38 supports the lower surface of the bottom base portion 26 and is parallel to the upper surface 14 of the top base portion 24, which in turn is preferably flush with the upper surface of the denture 40. Conventional adhesive material inert to an oral environment, such as acrylic cement 44, fills the volumes of the recess 38 not occupied by the base 14 to secure the base 14 to the denture 40. More particularly, the cement 44 fills the outwardly opening groove 32 and extends peripherally of the top base portion 24 to pro vide typically a substantially flush or planar surface beginning at the outer edge of the upwardly opening groove 32, extending across the upper surface of the top base portion 24 and the cement 44, and terminating in the upper surface of the denture 40 immediately adjacent the denture recess 38. (It should be noted that where the insert ll) is inserted in a highly convexly bowed segment of the denture 40, the denture recess 38 is formed deeper than the height of the base 14 and only the outer edge or rim of the top base portion 24 is flush with the upper surface of the denture 40 adjacent denturc recess 38.) The techniques for forming the denture recess 38 and trimming the cement flash to provide the flush surface will be described in detail hereinafter.

The head 12 and neck 16 of the insert 10 are removably secured within the receptor site 34 by mucosal tissue 36. The upper surface of the head 12 is engaged by the cooperatively configured and dimensioned upper surface of the receptor site 34, which is of sufficient depth to enable receipt within the site 34 of the entire head 12 and substantially the entire length of neck 16. While the side wall of the site 34 was originally basically cylindrical and of slightly lesser diameter than the maximum diameter of the head 12 to enable insertion of the head 12 into the resilient mucosal tissue 36 during the implantation procedure and promote its subsequent retention therein, the mucosal tissue 36 through natural resiliency and the natural tendency of tissue to heal and close over artificial body cavities has in time grown closely about and over the head 12 and, furthermore, extended into the downwardly opening groove 22 of the head 12 and the upwardly opening groove 32 of the base 14.

The filling of the downwardly opening groove 22 and upwardly opening groove 32 with resilient regenerated mucosal tissue 36 secures the insert 10 within the tissue 36 more firmly than would be possible if the bottom surface of the head 12 and the top surface of the base 14 were strictly planar. Similarly, the lesser diameter of the top base portion 24 relative to the bottom base portion 26 permits an extremely secure connection be tween the insert 10 and the denture 40 because it facilitates the escape of trapped air and exceee cement from the denture recess 38 during placement of the base 14 therein. Accordingly, the connections of the insert 10 to denture 40 and intramucosal tissue 36 are of exceptional stability and strength which, as will be recognized by those skilled in the denture art, implies greater comfort for the wearer and a diminished liklihood of subsequent loosening of the insert within its environ ment as a result of continued use.

The insert 10 is formed of conventional materials such as titanium alloy which are inert to an oral environment and of sufficient strength to withstand the forces applied thereto during placement and use thereof. Typically an implant 10 has a maximum width of about 0.6 centimeter across the bottom base portion 26 and a maximum height of about 0.6 centimeter from the bottom surface of the bottom base portion 26 to the top of the teat 20.

THE SLEEVE Referring now to FIGS. 3 and 4, in order to insure that the downwardly opening groove 22 and the upwardly opening groove 32 do not become filled with the adhesive cement 44 during cementing of the base l4 within denture recess 38, a removable sleeve 50 is also provided as part of the denture adhering system according to the present invention. The sleeve 50 comprises a thin-walled hollow cylinder normally ha\ ing an outer diameter substantially equal to the diameter of the top base portion 24 and an inner diameter slightly less than the maximum diameter of the head 12. The sleeve 50 is formed of a resilient composition so that when an end is manually pressed over head 12, it deforms slightly to permit slippage over and about convex head 12 and is subsequently t'rictionally retained there until intentionally removed after the cementing procc dure is completed.

The length of sleeve 50 is such that when the bottom end rests upon the upper surface of the top base por tion 24 (as it should during the cementing procedure the upper end extends upwardly at least above the point of maximum diameter of the head 12, and prefer ably substantially beyond the top of the teat 20. Thus the base 14 may be introduced into a cement-filled denture recess 38 without fear that the cement 44 will enter either of the vertically opening grooves 22, 32, while free access of the cement 44 to outwardly opening groove 30 is unimpaired. (The excess cement 44, of course, escapes denture recess 38 through the gap between the sides of denture recess 38 and the peripheral edges of the top base portion 26.) The sleeve 50 is preferably formed ofa transparent resilient non-stick material inert to the cement 44, such as nylon, so that it does not interfere with the dentist's field of vision and can be easily removed from any adjacent cement 44.

While the provision of a sleeve 50 having an outer di ameter equal to the maximum diameter of the top base portion 24 is desirable in that it eliminates the need for the removal of flash from the upper surface thereof, obviously the sleeve 50 may have a maximum diameter which is less than the maximum diameter of the top base portion 24 and any flash formed on the upper surface of the top base portion 24 may be removed during subsequent trimming by utilization of a trimming burr which has a cutting end extending inwardly over the portion of the upper surface in question. The sleeve 50 must, however, extend over or outwardly of the upwardly opening groove 32 on the top base portion 24 to protect the groove 32 from cement during the ccmenting procedure. and furthermore must also have a maximum diameter less than that of the bottom base portion 26 to avoid blockage of the escape route for cement 44.

THE DENTURE BURR Referring now to FIGS. and 6, in order to facilitate formation of the denture recess 38 and insure that it is of the proper diameter, depth and orientation for the desired positioning of the insert 10, a self-limiting selfleveling denture burr generally designated by the numeral 60 is also provided as part of the denture adhering system according to the present inventionv The den ture burr 60 comprises an elongated body portion 62 having a drill-engaging end 64, a cutting end 66. and an outwardly projecting flange 68 intermediate the ends.

The drill-engaging end 64 is of conventional design and adapted to be engaged by conventional means for rotation by common dental drills, for example by a friction engagement with the bit 69 of a hand piece. The cutting end 66 has an effective diameter equal to the maximum diameter of the base l4 that is, the cutting end 66 is configured and dimensioned to form a circular recess having a diameter substantially equal to that of the bottom base portion 26. The flange 68 is spaced from the cutting end 66 at least by the thickness of the base l4 that is. the end of the flange 68 closest to the tip of the cutting end 66 is spaced therefrom by at least the distance separating the upper surface of the top base portion 24 from the lower surface of the bottom base portion 26. It will be noted that the flange 68 serves a dual purpose. During drilling of the denture recess 38. the flange 68 eventually abuts against the adjacent surface of the denture 40 and acts as a stop to prevent overcutting of the recess 38 and, because the flange axis is normal to the axis of the burr 60 and parallel to the surface of the cutting end 66, the flat abutment of the circumferentially-extending flange 68 against the denture surface ensures that the base of the denture recess 38 is parallel to the denture surface in the immediate area of the denture recess 38 (and, thus, that the sides of denture recess 38 are normal to the immediately adjacent upper surface of the denture 40). Accordingly, the dentist preparing the denture recess 38 need only select the appropriate denture burr 60 for a particular insert 10 and continue his drilling of the denture 40 until the denture burr flange 68 is flush against the upper surface of the denture 40 at all points to insure that the denture recess 38 thus formed is of the appropriate diameter, depth and orientation relative to the denture surface.

It has been found desirable to provide the tip of the cutting end 66 with a shallow, tiny centered projection 70 to reduce skidding of the cutting end 66 along the upper surface of the denture 40.

The procedure for affixing the insert 10 to the denture 40 is relatively simple. The sleeve 50 is fitted over the head 12 and neck 16 of the insert 10. as shown in FIG. 11, and the insert bast 14 is then inserted into the recess 38 of the denture 40 with the upper surface of the top base portion 24 being flush with (or slightly below) the upper surface of the denture 40, a natural re sult of the denture recess 38 having been formed with the proper configuration and dimensions as a result of the use of the aforementioned denture burr 60. Acrylic cement 44 is next applied in the gap between the periphery of the upper base portion 24 and the side walls of the denture recess 38, insuring that the cement 44 completely fills the outwardly opening base groove 30. Alternatively or in addition, the denture recess 38 may be filled with cement 44 prior to insertion of the base 14 thereinto. After completion of the cementing proce dure, the sleeve 50 is slipped off the insert 10, after which it may be reused with other inserts of similar size.

To insure that the upper surface of the top base portion 24. the upper surface of the denture 40 closely adjacent thereto, and the upper surface of cement 44 therebetween form a flush planar surface and eliminate any upwardly-extending cement protrusions. any cement 44 which has been accidentally deposited on these upper surfaces (including the excess of cement between the upper surface of the denture 40 and the periphery of the top base portion 24 above the flush line) will be removed to reduce potential irritation of the mucosal tissue. (It will be noted that generally there is no "flash or excess cement on the upper surface of the top base portion 24 because that surface was covercti by the end of the removable sleeve 50 during the cementing procedure).

THE TRlMMlNG BURR Referring now to FIGS. 7 and 8, in order to facilitate removal of excess cement 44 from about and around the base l4 after the cementing procedure is completed, a self-centering trimming burr generally desig nated by the numeral 80 is provided as part of the denture adhering system according to the present invention. The trimming burr 80 comprises an elongated body 82 having a drill-engaging end 84 (similar to drillengaging end 64 and also adapted to be engaged for rotation by a drill) and a cutting end 86 for the removal of excess cement from the flush plane.

The cutting end 86 has a downwardly opening cavity 88 with an interior surface cooperatively configured and dimensioned to loosely receive and center itself upon at least a portion of the upper surface of the insert head 12. The generally concave interior upper surface of the burr cavity 88 will be centered on the generally convex upper surface of the head 12 a result of the interaction between the interior sidewall of cavity 88 and the top and sides of head [2 when the two are brought into engagement, thus aligning head teat 20 with the centrally located uppermost portion of the burr cavity 88. The interior length of the burr cavity 88 is at least equal to the distance between the upper surface of the head 12 and the upper surface of the top base portion 24 so that the cutting end extends at least to the plane of the upper surface of the top base portion 24 [when the insert head 12 is loosely seated in the burr cavity 88) and so can remove flash from above the desired flush plane. As shown in FIG. [2, the cutting end 86 extends outwardly beyond the maximum diameter of the top bsc portion 24 when the burr cavity 88 is seated on the head 12 and preferably inwardly over at least a portion of the top base portion 24 and outwardly beyond the maximum diameter of the base 14. Accord ingly, in the trimming procedure a dentist need only loosely seat the cutting end of the trimming burr 80 over the insert head 12 and press downwardly; the co operation of the burr cavity 88 and the insert head 12 will automatically center the trimming burr 80 about the head 12. When the trimming burr engages the upper surface of the top base portion 24, as indicated by an easily recognized difference in feel during drilling, the trimming procedure is completed.

Preferably the cutting end 86 of trimming burr 80 is provided with cutouts or side vents 90 extending from the tip thereof rearwardly through a length of the side wall of cavity 88 to facilitate escape of the ground flash 44 trimmed from the flush plane. Thus the trimming burr 80 has a self-cleaning centrifugal action during use which saves the dentist cleaning time and prevents an accumulation of ground trimmed flash within the cavity 88 where it could interfere with the cooperation between cutting end 86 and head 12 and leads to an offcenter or prematurely terminated trimming procedure.

To avoid rnetal-to-metal abrasion of the insert head 12 and the rotating trimming burr 80, the cavity 86 of trimming burr 80 is only loosely seated on the head 12 of the insert 10 and the length of the cavity is greater than the combined length of head 12 and neck 16 so that, when the tip of the cutting end 86 rests on the upper surface of the top base portion 24, the upper end of the cavity 88 is still slightly spaced above the upper surface of insert head 12.

Once the inserts 10 have been inserted into denture 40 and the flash has been trimmed. the denture may be properly positioned in the patient's mouth and pressed upwardly there-against so that the teats 20 leave slight.

temporary indentations in the mucosa] tissues precisely where the centers of the receptor sites 34 are to be formed. If desired, to provide an even clearer indication of the points at which the sites 34 are to be formed, marking paper with a pressure-transferrable dye of the type commonly used in the dental art may be inserted between the denture and the mucosa] tissue, so that upon closing of the patients mouth the well defined projections of the teats 20 against the paper leave sharp, clear dye marks on the surface of the mucosa] tissue. For even greater precision the teats 20 themselves may be formed with a pressure-transferrable marking dye or, alternatively, the dye may be applied to the teats 20 as a coating after the trimming proce dure.

THE TISSUE BURR Referring now to FIGS. 9 and 10, in order to facilitate preparation of a receptor site 34 in mucosal tissue 36 to engagingly receive the insert 10, a selflimiting and self-leveling tissue burr generally designated by numeral 100 is provided as part of the denture adhering system according to the present invention. The tissue burr ")0 comprises a body portion 102 having a drillengaging end 104, a cutting end 106 and an outwardly projecting flange 108 intermediate the ends 104 and 106. The drill-engaging end 104 is adapted to be engaged and rotated by a conventional dental drill; for example, by a latch fit into a contra-angle hand piece (not shown The cutting end 106 has a maximum effective diameter slightly less than the maximum diameter of the insert head 12, and the flange 108 is spaced from the cutting end approximately by the combined depth of the head and neck that is, the tip of the cutting end 106 is spaced from the near surface of the flange 108 by the distance separating the upper surface of the head 12 (actually teat 20) and the upper surface of the top base portion 24. The flange 108 performs functions analogous to those of flange 68 in the denture burr 60; it limits the depth of penetration of the cutting end 106 into the mucosa] tissue 36 and ensures the normal orientation of the cavity 34 by total peripheral abutment against immediately adjacent tissue 36, thus giving selflimiting and self-leveling action. Accordingly, during the site-forming procedure the dentist need only cor rectly apply the tissue burr 100 against the spot previously marked by the teat 20 to form a receptor site 34 of predetermined diameter, depth and orientation. The circumferentially-extending flange 108 by flush abutment against tissue 36 provides a site interior of predetermined configuration and diameter, limits action of the burr to a predetermined site depth, and ensures a site orientation which is normal to the adjacent mucosal tissue surface. Thus, use of the tissue burr [00 per mits the receptor site to be formed in a rapid and errorfree manner.

IN GENERAL The various burrs 60, 80, 100 are typically formed of stainless steel, carbide, or other conventional dental burr materials. Referring now in particular to FIGS 5, 7 and 9, it will be noted that along the body portion of each burr 60, 80. 100 is provided at least one circumferential indicator or marker groove 116. which serves simply as a means of distinguishing one burr from another. Denture burr 60 has a single marker groove l [6, trimming burr has a pair of marker grooves 116. and

tissue burr has three marker grooves 116. Obvi ously the marker grooves 116 may be omitted entirely or replaced or supplemented by printed, embossed. colored. or engraved indications which serve the same purpose.

When the insert is to be inserted into a highly concave segment of the denture 40, it will of course be impossible for the planar upper surface of the top base portion to be substantially flush with the contiguous upper surface of the denture due to the curvature of the latter. Where the curvature of the denture is so con cave that the flange 68 of the denture burr 60 would contact relatively remote portions of the upper surface of the denture 40 prior to the portions proximate to the denture recess 38 being formed, a denture burr 60 is selected in which the spacing between the cutting end 66 and the near face of the flange 68 is slightly greater than the depth of the base 12. In this manner a denture recess 38 is formed of sufficient depth to permit the entire base 12 to be seated within the denture recess 38 with no surface thereof or with only the peripheral upper surface of the top base portion 24 extending into the flush plane.

The individual accessories described herein above namely, the sleeve 50, the denture burr 60, the trimming burr 80 and the tissue burr 100- are all useful with an intramucosal insert 10 of predetermined size and configuration. With the insert 10, they form a denture adhering system or kit for fixing a denture in the mucosal tissue in a rapid and error-free procedure which will reduce the amount of pain-staking labor required on the part of the dentist, while at the same time providing the patient with a precision-fitted denture affording improved retention and stability at a greatly reduced cost.

Various embodiments of the present invention having been shown and described in detail, other modifications and variations thereon will now become readily apparent to those skilled in the art. Consequently. the spirit and scope of this invention should be considered as defined not by the foregoing disclosure, but only by the appended claims.

We claim:

I. An intramucosal insert for securing a denture to the mucosal tissue adjacent a patients jawbone Comprising A. a mushroom-shaped head adapted to be seated in mucosal tissue;

B. a base wider than said head and having a generally planar bottom portion and a generally planar top portion. said top base portion being substantially narrower than said bottom base portion and being undercut to provide an outwardly opening groove adapted to engagingly receive means for securing said base to a denture; and

C. a neck narrower than said head and connecting said head and said base, the underbody ofsaid head defining a downwardly opening groove disposed about said neck and adapted to cngagingly receive intramucosal tissue.

2. The intramucosal insert of claim I wherein the upper surface of said top base portion defines an u wardly opening groove disposed about said neck and adapted to engagingly receive intramucosal tissue.

3. The intramucosal insert of claim 2 wherein said upward opening groove of said base and said downwardly opening groove of said head are circular and vertically aligned.

4. The intramucosal insert of claim 1 wherein said head. neck and base of said insert each have a substan- 5 tially circular peripheral configuration.

5. The intramucosal insert of claim 1 wherein said oral insert is a unitary construction composed of a metal inert to an oral environment.

6. The intramucosal insert of claim 1 wherein the upper surface of said head is convex.

7. The intramucosal insert of claim 1 wherein said head has an upwardly projecting teat at the top thereof.

8. The intramucosal insert of claim 7 wherein said insert additionally contains pressure-transferrable marking means disposed on said teat, whereby when said teat is pressed against intramucosal tissue a mark is left thereon at the point of contact.

9. The intramucosal insert of claim 8 wherein said head has a convex upper surface about said teat.

10. The intramucosal insert of claim I wherein the maximum width of said top base portion is closer to the maximum width of said head than the maximum width of said bottom base portion.

11. A denture adhering system comprising the intramucosal insert of claim 1 in combination with A. a plastic denture having a surface defining a plu rality of recesses;

B. a plurality of the intramucosal inserts of claim 1 having their bases seated in said recesses; and

C. adhesive means disposed within said outwardly ex tending grooves. over a portion of said bottom base portions, and laterally of said top base portions.

12. A denture adhering system comprising the intramucosal insert of claim 1 in combination with a sleeve adapted to be removably slipped over said head and neck of said insert prior to cementing of said insert to a denture comprising A. a bottom end adapted to be supported on the upper surface of said top base portion outwardly of said upwardly opening groove thereof; and

B. a sidewall upwardly extending from said bottom end and snugly engaging the periphery of said head when said bottom end is supported on said upper surface;

whereby said sleeve protects said downwardly opening groove from being filled with cement during ce menting of said insert in a denture.

13. A denture adhering system comprising the in tramucosal insert of claim 2 in combination with a sleeve adapted to be removably slipped over said head and neck of said insert during cementing of said im plant to a denture comprising A. a bottom end adapted to be supported on the upper surface of said top base portion outwardly of said upwardly opening groove thereof. and

B. a sidewall extending upwardly from said bottom end and snugly engaging the periphery of said head outwardly of said downwardly opening groove thereof. when said bottom end is supported on said upper surface;

whereby said sleeve protects said downwardly and upwardly opening grooves from being filled with cement during cementing of said insert to a denture.

14. The system of claim 13 wherein said head. neck and base are each of generally circular configuration and said upwardly and downwardly opening grooves define generally concentric circles of substantially equal diameter, and wherein said sleeve is formed of resilient material and has as a normal configuration a hollow cylinder of an inner diameter slightly less than the maximum diameter of said head and an outer diameter approximately equal to the maximum diameter of said top base portion and substantially less than the maximum diameter of said bottom base portion.

15. The system of claim 12 wherein said sleeve is a hollow cylinder of resilient non-stick material having a maximum width at least equal to the maximum width of said top base portion.

16. A denture adhering system comprising the intramucosal insert of claim 1 in combination with a selflimiting self leveling denture burr for preparing in a denture a recess of predetermined diameter. depth and orientation to receive said insert comprising an elongated body having A. a drill-engaging end adapted to be engaged for rotation by a drill;

B. a cutting end having a maximum effective diameter substantially equal to the maximum diameter of said base; and

C. flange means extending outwardly of said body portion and spaced from said cutting end by approximately the maximum depth of said base to prevent overcutting ofa recess by abutment against the adjacent surface of the denture.

17. The system of claim 16 wherein said flange means of said denture burr is spaced from said cutting end by slightly more than the maximum depth of said base to ensure that the entire upper surface of said top base portion is disposable below a concave curved upper surface of the denture.

18. A denture adhering system comprising the in tramucosal insert of claim 1 in combination with a selfcentering trimming burr for removing excess cement from adjacent said base after said base has been cemented to a denture comprising an elongated body having A. a drill-engaging end adapted to be engaged for rotation by a drill; and

B. a cutting end having a downwardly opening cavity with an interior surface cooperatively configured and dimensioned to loosely receive and center itself upon at least a portion of the upper surface of said head and an interior length at least the distance between the upper surface of said head and the upper surface of said top base portion;

whereby said cavity length permits removal of excess cement from above the plane of the upper surface of said top base portion when said cavity is seated over said head, and whereby said interior surface cooperates with said head to center said trimming burr over said insert.

19. The system of claim 18 wherein said interior cavity length slightly exceeds said distance, and wherein said cutting end extends inwardly over at least part of said top base portion and outwardly beyond the maximum diameter of said top base portion when said cavity is seated over said head.

20. The system of claim 18 wherein said cutting end extends outwardly beyond the maximum diameter of said base when said cavity is seated over said head, and wherein said cutting end is provided with side vents to enable self-cleaning action during rotation thereof.

2]. A denture adhering system comprising the intramucosal insert of Claim 1 in combination with a selflimiting self leveling tissue burr for preparing in mucosal tissue a receptor site of predetermined diameter, depth and orientation to engagingly receive said insert comprising an elongated body having A. a drill-engaging end adapted to be engaged for rotation by a drill;

B. a cutting end having a maximum effective diameter slightly less than the maximum diameter of said head; and

C. flange means extending outwardly of said body portion and spaced from said cutting end by approximately the combined depth of said head and neck to prevent over-cutting of tissue by abutment against the surface of adjacent tissue.

22. A dental kit for affixing a denture to the mucosal tissue of a patients jawbone comprising A. an oral insert having a head adapted to secure said insert to mucosal tissue, a base adapted to be cc' mented to a denture to secure said insert to a den ture, and a neck connecting said base and head to operatively connect the denture to the intramucosal tissue, said head and said base having vertically aligned, facing grooves about said neck, and said base having a top portion and a bottom portion, said top portion being of reduced diameter relative to said bottom portion;

B. a self-limiting self-leveling denture burr for preparation in the denture of a recess configured and dimensioned to receive said base;

C. a protective non-stick resilient sleeve adapted to removably cover portions of said insert to protect said portions during cementing of said base in the denture recess.

D. a self-centering trimming burr for removal of excess cement from said base and the denture and provide a flush surface after cementing; and

E. a self-limiting self-leveling tissue burr for preparation in mucosal tissue of a receptor site cavity configured and dimensioned to receive said head and neck.

23. The intoramucosal insert of claim 1 wherein said bottom base portion is imperforate. 

1. An intramucosal insert for securing a denture to the mucosal tissue adjacent a patient''s jawbone comprising A. a mushroom-shaped head adapted to be seated in mucosal tissue; B. a base wider than said head and having a generally planar bottom portion and a generally planar top portion, said top base portion being substantially narrower than said bottom base portion and being undercut to provide an outwardly opening groove adapted to engagingly receive means for securing said base to a denture; and C. a neck narrower than said head and connecting said head and said base, the underbody of said head defining a downwardly opening groove disposed about said neck and adapted to engagingly receive intramucosal tissue.
 2. The intramucosal insert of claim 1 wherein the upper surface of said top base portion defines an upwardly opening groove disposed about said neck and adapted to engagingly receive intramucosal tissue.
 3. The intramucosal insert of claim 2 wherein said upward opening groove of said base and said downwardly opening groove of said head are circular and vertically aligned.
 4. The intramucosal insert of claim 1 wherein said head, neck and base of said insert each have a substantially circular peripheral configuration.
 5. The intramucosal insert of claim 1 wherein said oral insert is a unitary construction composed of a metal inert to an oral environment.
 6. The intramucosal insert of claim 1 wherein the upper surface of said head is convex.
 7. The intramucosal insert of claim 1 wherein said head has an upwardly projecting teat at the top thereof.
 8. The intramucosal insert of claim 7 wherein said insert additionally contains pressure-transferrable marking means disposed on said teat, whereby when said teat is pressed against intramucosal tissue a mark is left thereon at the point of contact.
 9. The intramucosal insert of claim 8 wherein said head has a convex upper surface about said teat.
 10. The intramucosal insert of claim 1 wherein the maximum width of said top base portion is closer to the maximum width of said head than the maxImum width of said bottom base portion.
 11. A denture adhering system comprising the intramucosal insert of claim 1 in combination with A. a plastic denture having a surface defining a plurality of recesses; B. a plurality of the intramucosal inserts of claim 1 having their bases seated in said recesses; and C. adhesive means disposed within said outwardly extending grooves, over a portion of said bottom base portions, and laterally of said top base portions.
 12. A denture adhering system comprising the intramucosal insert of claim 1 in combination with a sleeve adapted to be removably slipped over said head and neck of said insert prior to cementing of said insert to a denture comprising A. a bottom end adapted to be supported on the upper surface of said top base portion outwardly of said upwardly opening groove thereof; and B. a sidewall upwardly extending from said bottom end and snugly engaging the periphery of said head when said bottom end is supported on said upper surface; whereby said sleeve protects said downwardly opening groove from being filled with cement during cementing of said insert in a denture.
 13. A denture adhering system comprising the intramucosal insert of claim 2 in combination with a sleeve adapted to be removably slipped over said head and neck of said insert during cementing of said implant to a denture comprising A. a bottom end adapted to be supported on the upper surface of said top base portion outwardly of said upwardly opening groove thereof, and B. a sidewall extending upwardly from said bottom end and snugly engaging the periphery of said head outwardly of said downwardly opening groove thereof, when said bottom end is supported on said upper surface; whereby said sleeve protects said downwardly and upwardly opening grooves from being filled with cement during cementing of said insert to a denture.
 14. The system of claim 13 wherein said head, neck and base are each of generally circular configuration and said upwardly and downwardly opening grooves define generally concentric circles of substantially equal diameter, and wherein said sleeve is formed of resilient material and has as a normal configuration a hollow cylinder of an inner diameter slightly less than the maximum diameter of said head and an outer diameter approximately equal to the maximum diameter of said top base portion and substantially less than the maximum diameter of said bottom base portion.
 15. The system of claim 12 wherein said sleeve is a hollow cylinder of resilient non-stick material having a maximum width at least equal to the maximum width of said top base portion.
 16. A denture adhering system comprising the intramucosal insert of claim 1 in combination with a self-limiting self leveling denture burr for preparing in a denture a recess of predetermined diameter, depth and orientation to receive said insert comprising an elongated body having A. a drill-engaging end adapted to be engaged for rotation by a drill; B. a cutting end having a maximum effective diameter substantially equal to the maximum diameter of said base; and C. flange means extending outwardly of said body portion and spaced from said cutting end by approximately the maximum depth of said base to prevent overcutting of a recess by abutment against the adjacent surface of the denture.
 17. The system of claim 16 wherein said flange means of said denture burr is spaced from said cutting end by slightly more than the maximum depth of said base to ensure that the entire upper surface of said top base portion is disposable below a concave curved upper surface of the denture.
 18. A denture adhering system comprising the intramucosal insert of claim 1 in combination with a self-centering trimming burr for removing excess cement from adjacent said base after said base has been cemented to a denture comprising an elongated body having A. a drill-engaging end adapted to be eNgaged for rotation by a drill; and B. a cutting end having a downwardly opening cavity with an interior surface cooperatively configured and dimensioned to loosely receive and center itself upon at least a portion of the upper surface of said head and an interior length at least the distance between the upper surface of said head and the upper surface of said top base portion; whereby said cavity length permits removal of excess cement from above the plane of the upper surface of said top base portion when said cavity is seated over said head, and whereby said interior surface cooperates with said head to center said trimming burr over said insert.
 19. The system of claim 18 wherein said interior cavity length slightly exceeds said distance, and wherein said cutting end extends inwardly over at least part of said top base portion and outwardly beyond the maximum diameter of said top base portion when said cavity is seated over said head.
 20. The system of claim 18 wherein said cutting end extends outwardly beyond the maximum diameter of said base when said cavity is seated over said head, and wherein said cutting end is provided with side vents to enable self-cleaning action during rotation thereof.
 21. A denture adhering system comprising the intramucosal insert of Claim 1 in combination with a self-limiting self leveling tissue burr for preparing in mucosal tissue a receptor site of predetermined diameter, depth and orientation to engagingly receive said insert comprising an elongated body having A. a drill-engaging end adapted to be engaged for rotation by a drill; B. a cutting end having a maximum effective diameter slightly less than the maximum diameter of said head; and C. flange means extending outwardly of said body portion and spaced from said cutting end by approximately the combined depth of said head and neck to prevent over-cutting of tissue by abutment against the surface of adjacent tissue.
 22. A dental kit for affixing a denture to the mucosal tissue of a patient''s jawbone comprising A. an oral insert having a head adapted to secure said insert to mucosal tissue, a base adapted to be cemented to a denture to secure said insert to a denture, and a neck connecting said base and head to operatively connect the denture to the intramucosal tissue, said head and said base having vertically aligned, facing grooves about said neck, and said base having a top portion and a bottom portion, said top portion being of reduced diameter relative to said bottom portion; B. a self-limiting self-leveling denture burr for preparation in the denture of a recess configured and dimensioned to receive said base; C. a protective non-stick resilient sleeve adapted to removably cover portions of said insert to protect said portions during cementing of said base in the denture recess. D. a self-centering trimming burr for removal of excess cement from said base and the denture and provide a flush surface after cementing; and E. a self-limiting self-leveling tissue burr for preparation in mucosal tissue of a receptor site cavity configured and dimensioned to receive said head and neck.
 23. The intoramucosal insert of claim 1 wherein said bottom base portion is imperforate. 